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Case study · Skilled nursing & rehabilitation · Tennessee · 2016–2021
A skilled nursing and rehabilitation facility running a short-term rehab program of 20 to 25 residents, with regulatory exposure that needed the same attention as the census. Over a five-year leadership period the program was rebuilt around Medicare Part A and managed-care admissions, and compliance was run as a daily discipline rather than a pre-survey scramble.
Short-term rehab average daily census
Monthly admissions, Medicare Part A and managed care
Added revenue at the higher operating level
Deficiencies on the October 2019 annual health survey
The situation
Short-term rehabilitation — the facility’s highest-value line — was running at roughly 20 to 25 residents a day. Referral relationships, admissions capacity and clinical readiness were not organized to take more.
At the same time, operational and regulatory vulnerabilities needed to be identified and closed through the department leaders who would have to own the fixes.
What had to happen
What was done
Operational and regulatory vulnerabilities assessed and prioritized.
Targeted improvement plans built, implemented and followed through with departmental leaders.
Short-term rehab volume expanded across Medicare Part A and managed care — more admissions a month and a higher daily census.
Ongoing compliance oversight and departmental accountability in front of every annual health inspection.
What changed
Short-term rehab average daily census rose from about 20–25 to 45–55 — roughly 122% at the midpoints — with the program taking more than 50 admissions a month. At the higher operating level that was about $250,000 a month in additional revenue, a run rate of roughly $3 million a year.
The facility recorded a deficiency-free annual health survey in October 2019.
About these results
This engagement reflects the individual operating experience of Mainspring’s leadership before the firm was formed; it was not delivered as a Mainspring corporate engagement. Figures are as reported by the leader responsible for the period, and survey results are as recorded by the state survey agency. The community is not named; references are available to serious enquiries.
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